Healthcare Provider Details

I. General information

NPI: 1134798697
Provider Name (Legal Business Name): BRIGHTER STRIDES ABA GA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2021
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10700 ABBOTTS BRIDGE RD STE 170
JOHNS CREEK GA
30097-8461
US

IV. Provider business mailing address

10700 ABBOTTS BRIDGE RD STE 170
JOHNS CREEK GA
30097-8461
US

V. Phone/Fax

Practice location:
  • Phone: 770-200-5155
  • Fax:
Mailing address:
  • Phone: 770-200-5155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: LEAH KURTZ
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 410-609-6357